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Cotinine in Serum/Plasma (24-Hour Urine Total)

Published: August 9, 2026Updated: August 16, 2026

This test measures cotinine, a breakdown product of nicotine, to help assess recent nicotine exposure or smoking status. It’s often used in screening for tobacco use.

Quick summary

["Cotinine helps track nicotine exposure and supports smoking cessation monitoring."]

Medically reviewed by WellAlly Editorial TeamLast reviewed August 16, 2026Editorial policy

Key facts at a glance

LOINC
61128-5
Short code
Cotinine SerPl Ql
Synonyms
Cotinine SerPl Ql
Category
chemistry
Sample
serum
Container
Red-top tube (SST)
Units
N/A
Fasting
false
Population
adult
Sex
all
Age range
18–65 years
Specimen volume
5 mL
Stability
Room temperature: 4h, Refrigerated: 24h, Frozen: 7d
Hemolysis max
500
Lipemia max
1000
Icterus max
500
TAT
4–24 hours
Order
routine

Why Is This Test Done?

Your healthcare provider may order this test if they suspect recent tobacco use, evaluate nicotine dependence, or monitor progress in quitting smoking. It can also be used in research or workplace safety assessments.

What Does the Test Measure?

Cotinine is a metabolite of nicotine found in both blood (serum/plasma) and urine. High levels indicate recent exposure to nicotine, often from smoking or vaping. The test helps distinguish between short-term exposure and long-term use.

How Is the Test Performed?

For serum/plasma: A blood sample is drawn from a vein, typically in the arm. For urine: A timed urine sample (usually 24 hours) is collected. Results are interpreted based on the concentration of cotinine detected.

What Do Results Mean?

Results are qualitative (positive/negative) or quantitative (concentration levels), depending on the test. Positive results suggest recent nicotine exposure, while negative results indicate no detectable exposure. Interpretation depends on clinical context, such as whether the test is screening or confirmatory.

Clinical interpretation

How abnormal results are interpreted and what conditions they suggest.

Clinical Significance

Short name

Cotinine Screen

Frequently asked questions

How long does it take to get results from this test?
Results are typically available within 1–3 business days, depending on lab processing times. Follow-up with your healthcare provider can help clarify results and next steps.
Can I drink coffee or eat before this test?
No special preparation is needed for serum/plasma cotinine tests. For urine tests, follow your provider’s instructions regarding diet, hydration, or other substances that might affect results.
Is this test covered by insurance?
Coverage depends on your insurance plan and clinical indication. Check with your provider or insurance company to confirm if this test is covered under your specific circumstances.
  1. 1
    MedlinePlus — Laboratory TestsSource
  2. 2
    Lab Tests OnlineSource
  3. 3
    Mayo Clinic — Tests & ProceduresSource

Click any link to access the full source. PubMed Central (PMC) links provide free full-text access.

This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment.

Medical Disclaimer

This content is for general informational and educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the guidance of a qualified healthcare provider with any questions you have about a medical condition, and never disregard professional medical advice or delay seeking it because of something you read here.

If you think you may have a medical emergency, call your local emergency number or go to the nearest emergency department immediately.

Medically reviewed by WellAlly Editorial Team Last reviewed August 16, 2026. · Read our editorial policy